Subject:
|
IGMD 6: Hormonal regulation NCEBP 1: Molecular epidemiology NCEBP 2: Evaluation of complex medical interventions IGMD 9: Renal disorder |
Organization:
|
Endocrinology Nephrology Surgery Internal Medicine Health Evidence Laboratory of Genetic, Endocrine and Metabolic Diseases |
Former Organization:
|
Epidemiology, Biostatistics & HTA
|
Journal title:
|
Head and Neck-journal for the Sciences and Specialties of the Head and Neck
|
Abstract:
|
BACKGROUND: In renal hyperparathyroidism, it remains unclear whether intraoperative parathyroid hormone (PTH) measurements can predict postoperative outcome and guide the extent of surgical exploration. METHODS: In 42 parathyroidectomies for renal hyperparathyroidism, we analyzed the predictive value of the Miami Criterion of 50% intraoperative PTH decrease. We used receiver operating characteristic (ROC) curves to find the criterion with the best diagnostic performance. We also investigated whether the whole PTH assay improved accuracy. RESULTS: Twenty-six operations (62%) resulted in normal postoperative PTH. With the Miami Criterion, cure was predicted with a sensitivity of 95% and specificity of only 8%. Specificity could be improved to 50% using a 70% PTH decrease as cut-off level. The whole PTH assay did not improve accuracy. CONCLUSION: Prediction of cure after parathyroidectomy for renal hyperparathyroidism might be improved with a criterion of 70% PTH decrease 10 minutes after excision of all parathyroid glands. Prospective analysis needs to validate this new criterion.
|